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Relationships 85

June
2009

Every month Maggi Stamp, a qualified and experienced relationship counsellor for Relate and in private practice, writes about some of the emotional challenges we meet in later life.

For reasons of confidentiality Maggi never writes about a particular person's problems unless you have sent one in to be answered, but all her examples are based on problems raised by clients, family and friends over the years.

Can there be compensations with dementia?

Valerie is 88 years old and lives in sheltered accommodation in reasonable comfort and contentment. Since being in her care home she has adjusted well to being near others of her age and of similar infirmity of memory.

Recently her daughter and son-in-law visited, as usual, to find her sitting with a total stranger. She greeted her daughter with the words “You know Maurice my brother-in-law of course, don’t you?” Sarah was well aware that Uncle Maurice had died some years ago, but said hello to the stand-in ‘Maurice’ and was greeted warmly in return. When it came to taking Val out for her regular walk into town for tea and cake, Maurice came too, arm in arm with her. Sarah and her husband said nothing, but noted with amusement that the elderly new couple seemed completely at ease and happy in each other’s company.

It is some time since Valerie began to lose her short-term memory and at first was distressed and panicky as a result. She became depressed and difficult and needed a great deal of attention in order to stay in her own home. She was extremely anxious about moving into care and was sure that she would be treated badly if she left her home. This made it a hard decision to take for her two daughters, once it was obvious that Valerie needed full time care. She would wander out of the house during the night, get dressed in an overcoat to go to bed, forget to cook food that should be cooked and cook things best eaten raw, like lettuce. At times she would forget to eat at all. She could not be left to live alone yet her daughters were in no position to take her in. They took it in turns to drive many miles to spend time stocking her fridge, clearing the accumulation of half eaten meals and wash and clean for her.

The move, once the time came, was fraught with protestations from Valerie. She was convinced this was all a plot to get rid of her. This was hard not only for her but for her daughters, who had tried their best to preserve mum’s quality of life in her own home. They agonised over what to do, when and how to break they news and how to select the best care home. They remember this experience as one full of worry and fear. What if it hastened her deterioration or she was more unhappy than ever? Now they were removing their mum from their childhood home, trying to settle her elsewhere and empty Valerie’s house in order to sell it to pay for Valerie’s care. The whole exercise felt risky and negative.

Valerie remembers nothing of this time, though often mentions having seen one of her friends for a chat. Most of them have predeceased her and just one is able to visit. These pleasurable interludes take place entirely in her mind and seem just as enjoyable as if they were real. It was hard at first for Sarah and her sister to suspend logic and go along with Valerie’s accounts of her activities, but after a while the urge to bring mum back into ‘the real world’ subsided and they began to ask how the friend was and conversation followed more easily and with less distress for Valerie. This, in turn, gave them less stress as they began to realise that their mother had entered a world that she remembered with pleasure and knew well. To find a way of talking with her about that world was a way of keeping contact with her and giving her a feeling of stability.

And now there is Maurice. He too is losing his memory. He lives in the care home and, according to the care-workers, spends most days with Valerie in gentle companionship. He holds Valerie’s hand and quietly sits with her when she takes a nap and they chatter on, not always listening to each other but drawing comfort from the friendship anyway.

“How can I say that their world is fantasy? Who am I to judge if they are telling ‘the truth’? It is their new world and new reality. What I see is two old folk living in their memories,” said Sarah. She understands that these events happened to them once and now they are calling on the store of experiences to create something that amuses, touches, interests, and best of all gives them reassurance. Sarah sees how mum is coping with a stage of life many of us dread. Valerie is still showing her daughters how to manage the future, leading the way.

A friend of mine has recently moved her father over 90 miles to live in a little flat closer to her. Although he is still able to live alone and is not anywhere near as forgetful as Valerie, he nonetheless needs to be visited almost every day and have help with shopping, cooking and cleaning. He is still mobile but much prefers to observe life around him than actively take part. Many people would search for somewhere quiet, with a lovely view from the windows. My friend has wisely found him a flat that overlooks an area that is buzzing with activity. It is in a main shopping area and has several building sites opposite. He spends much of his day sitting at his window keeping an eye on the work going on and the shoppers hurrying by with their bags, trolleys and buggies. He will also venture out to ask the builders questions about their work. This passes his time and gives him something to talk about when his daughter comes to take him out which she finds waters down the criticism he has developed a habit of slipping into whenever she finds time in her packed days to spend with him.

In both of these cases the parent had become vulnerable and difficult. With strength, foresight, consideration and respectful acceptance their children had found a way of easing them into a way of life that was safer and in different ways stimulating. This is far from simple. Parental reliance often comes at a time in life when the son or daughter is approaching retirement themselves, looking forward to less pressure, more time to do things that they haven’t had time for, travel, gardening, being with grandchildren, just doing nothing for a while – or, in these straightened times, trying to work out how to cope on a much smaller pension than planned for. They will also be experiencing the frustrating dips in energy that tell them time is passing rather faster than before – or so it seems – when there appears to be more to do somehow!

But, out of love or out of duty, if parents have survived into their late eighties or nineties, they are our responsibility. It doesn’t necessarily mean we must have them in our home, though many feel that is what they wish to offer. It does mean that we need to consider carefully and generously, what is best for mum or dad in their final years. Get this balance right and our old folks can still surprise us and show us the way.

The UK Alzheimers Society website has much helpful and supportive information as well as an excellent section containing book reviews.www.alzheimers.org.uk